How to listen, offer support, and take the next step when someone you love refuses therapy.
When someone tells you they’re thinking about suicide, it can leave you terrified of saying the wrong thing. You want to help them. You want them safe. And when they refuse therapy, you may feel helpless.
But refusing therapy does not mean every door is closed. You can still listen, offer support, and help them take a next step.
Start by listening
Our first instinct may be to convince someone they have reasons to live by reminding them of their children, their future, or the people who love them. We might say we wouldn’t know what to do without them.
I have said those words because I didn’t know what else to say. I tried to get the person to stop looking at how they felt and think about how others would feel if they died, including me. I understand now that saying, “I couldn’t handle it if you left,” can make the conversation about my fear while they’re struggling to get through the day. I wanted them to know they mattered to me, but they also needed me to hear what they were telling me.
Those words may come from love, but they can add guilt to someone who is already overwhelmed.
Instead, try making room for what they’re actually feeling.
Say things like:
“I’m glad you told me.”
“I care about you, and I want to understand.”
“You don’t have to pretend you’re doing okay.”
You don’t need to have an answer for everything they say. Just listen without arguing, judging, or rushing them toward a positive thought. Take their pain seriously.
Ask direct questions
It can feel frightening to say the word suicide. But asking directly doesn’t put the idea in someone’s head. It gives them a chance to tell you what they’re experiencing.
Ask plainly:
“Are you thinking about killing yourself?”
If they say yes, ask whether they have a plan, access to what they would use, and whether they intend to act now.
These questions help you understand how urgently they need support. Someone with no plan still deserves help.
Get curious about their refusal of therapy
“I won’t go to therapy” can mean many things.
Maybe they had a bad experience. Maybe they’re afraid of being judged. Maybe money is an obstacle, or finding someone feels impossible.
Ask:
“What worries you about getting help?”
Their answer gives you a place to start. You might offer to help find a provider, sit beside them while they make a call, or accompany them to an appointment.
You could say:
“You don’t have to decide about ongoing therapy today. Would you be willing to talk with a crisis counselor about this situation while I sit with you?”
In the United States, you can call or text 988 together. You can also contact 988 yourself for guidance about someone you’re worried about. (I wish I had known this sooner. It would have been helpful last month when dealing with someone I love.) You do not need to persuade them to call before seeking support yourself.
Know when immediate help is needed
If someone has already taken an overdose, seriously injured themselves, or is about to act on suicidal thoughts, call your local emergency number immediately, even if they object. Stay with them if you can do so safely.
When possible, safely limit access to firearms, medications, and other things they could use to hurt themselves. Do not put yourself in danger trying to take something away. Do not promise them that you will keep their suicidal intentions secret. Bring in support.
Keep showing up, and involve others
Support matters after the first conversation, too. Check in again. Offer something specific: a meal, company, a ride to an appointment, or help making a phone call. Help them build connections with trusted people and professional care.
You can love someone deeply and still admit you need help supporting them. I learned something about the limits of what I could carry after my son died by suicide. My children were looking to me for grief support while I was struggling to make it through each day myself. I apologized, and I told them, “I do not know how to help you because I am going through the same thing.”
I had to go back to work shortly afterward, and I didn’t want to be there. I wanted to be home, wallowing in my grief, without having to put on a face for anyone. I didn’t know what I needed. But I knew what I wanted. I wanted to be left alone.
A customer came in and noticed my expression. She asked if I was okay. I told her no and that I had just lost my son.
The next time she came in, she brought me a plant in a cute little smiling snail planter. She said it was to remind me to smile. That small gesture meant more to me than anything anyone said or did. She had noticed my pain and remembered me after she left.
Sometimes caring for someone starts there: paying attention, remembering, and showing up with something they never would have asked for. A gift cannot replace crisis support, but that experience showed me how much a thoughtful act can mean when someone is hurting.
When you’re not sure what to say, try this:
“I hear how much you’re hurting. I’m here for you. Let’s find someone who can help us through this.”
Resources:
In the U.S.
- 988 Suicide & Crisis Lifeline: Call or text 988, or chat at 988lifeline.org. It’s free and open 24/7. You can also contact 988 if you’re worried about someone else.
- Spanish: Call 988 and press 2, or text AYUDA to 988.
- Veterans: Call 988 and press 1.
- Deaf or hard of hearing: Use a videophone, text 988, or chat at 988lifeline.org.
- Emergencies: If someone has already harmed themselves or is about to, call 911.
Outside the U.S.
- Go to FindAHelpline.com and select your country. If someone is in immediate danger, call your local emergency number.
Disclaimer:
I write from firsthand experience with suicide, including my own attempt and the loss of my son. I share this to offer understanding and support, but I am not a licensed mental health professional. This article is not a substitute for professional care or emergency help.
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